Sometimes it's not necessarily a good thing to be too experienced.

If the doctor has too much experience in diagnosis, it is easy to form blind confidence. In diagnosis, it is very easy to make subjective assumptions, which can lead to the occurrence of being slapped in the face.

Director Xue Yan was very lucky this time, after all, she was only in the diagnosis and gave a treatment plan too early.

If it weren't for the fact that the patient secretly went live during the visit, she could even directly tell the patient that the previous treatment plan was not suitable and that the plan needed to be changed.

This is in line with the diagnosis and treatment procedures, and no one can find fault with it.

Now I feel that it is difficult to ride a tiger, and in the final analysis, what I am worried about is the damage to the image of the department.

At least 10,000 or more viewers were online at the time of the patient's consultation, and this publicity was no less powerful than that of ordinary local TV interviews.

"Patients with coronary heart disease, myocardial infarction, coupled with the weakness of the body itself, cardiovascular interventional surgery, unclogging blood vessels is still the first choice. As for how to do the surgery, I think you can try reverse thinking. ”

What Zhou Can is best at is reverse thinking.

"How?"

She was a little puzzled.

"Normally, cardiovascular interventional procedures are entered through the femoral artery. If the blockage of the blood vessel is too severe, or even calcification, the guidewire may not be able to pass through. Then you can consider entering from the other end of the blood vessel, and reverse opening is also the same therapeutic effect. ”

Zhou Can talked eloquently.

From the patient's films, it can be concluded that the patient's blocked arteries have at least multiple calcified spots. It is also the most common condition of severe cardiovascular disease.

The lining of the blood vessels is calcified and blocked, which can seriously increase the difficulty of the guidewire passing.

"Reverse through?"

Director Xueyan was extremely shocked after listening to Zhou Can's surgical plan.

"When the teacher was alive, he didn't seem to teach us such a treatment plan, right?"

She thinks she has been very attentive to her studies and is unlikely to make major mistakes.

However, every time she encounters a difficult case, Zhou Can can always give a treatment plan or pathological dialectical ideas that she has not mastered.

The cardiovascular intervention plan given this time made her feel refreshed.

"When I was training in cardiovascular medicine, I once read in a medical journal that Academician Ge had undergone a similar operation. He's going to make it, and I think it's at least worth our try. Even if it fails, the vascular intervention procedure will be very less invasive to the patient and will not lead to serious consequences such as patient death. ”

Zhou Can is full of expectations for this super difficult cardiovascular interventional surgery.

A challenge is often a breakthrough.

"Great! Finally have a good plan, let's continue to discuss the implementation and preparation of the surgical plan. ”

After listening to this, Director Xue Yan showed a relieved and relaxed smile on her face for the first time.

As a department head, I am under a lot of pressure than others.

……

After more than half an hour of discussion, the two finally determined the surgical plan, and stated that Zhou Can would be in charge of the operation.

Interventional surgery and endoscopic surgery, Zhou Can does have a super high talent that ordinary people can't reach.

And he's already very strong now.

Both implantation and injection are level 5, and all of them have reached the level of deputy director. It is more than enough to do interventional surgery of general difficulty.

However, this time we have to face a very difficult cardiovascular interventional surgery, and if the injection and implantation can be upgraded to level 6, the certainty will be greater.

It is not possible for a patient to wait until he has been promoted to the next level of treatment.

The only way to do that is to bite the bullet.

Fortunately, the risk of this interventional surgery is low, and at most it is just a failure and a slap in the face.

He made an agreement with Director Xueyan to start the operation at about 7 o'clock in the evening.

The choice of evening surgery is mainly to cooperate with Zhou Can's work arrangement.

Back in the emergency department, Zhou Can immediately threw himself into the crazy operation, not mentioning it.

It's already past two o'clock in the afternoon.

Yang Zhi and Pu Dingdong have already begun to deal with some minor surgeries within their capabilities.

Under normal circumstances, Zhou Can sits in the morning, and around 1 pm, the members of the surgical team will arrive at the operating room on time.

"Doctor Zhou, come on!"

Yang Zhi is treating a patient with a subcutaneous abscess. Debridement is required, and Pu Dingdong is an assistant next to him.

Qiao Yu and Ma Xiaolan provided equipment and toured offstage.

They were all very happy to see Zhou Can come in.

Zhou Can is the absolute core of this surgical team.

"It's okay, it's okay, you do it!"

Zhou Can stood by and watched Yang Zhi operate.

"You're more skilled and faster. There are a lot of surgical patients out there waiting for you to come to the operation, and I can't afford to delay any longer. Come on! Wait until next time when I'm not busy, I'll take it slowly. ”

The speed of Yang Zhi's surgery was far inferior to Zhou Can.

He didn't dare to occupy the pit and not.

When Zhou Can came in just now, he did see many surgical patients waiting outside. The pre-linen room is full, not to mention the corridor outside.

"Okay, then you'll be on the side."

After Zhou Can took over, he quickly sucked up the unsucked concentrated liquid, and then began to debride the patient.

The goal of abscess debridement is to remove infected necrotic tissue and allow the patient to recover quickly.

Sixth-level debridement, plus sixth-level incision and sixth-level dissection, and now let Zhou Can remove this abscess cavity, it is simply a piece of cake.

The scalpel turned into a magic wand in his hand.

Everywhere you go, the necrotic tissue of the abscess cavity, the preservation or removal of the infected part, are all decided in an instant.

Brush Brush Brush!

The knife reaches the flesh, the blood vessels are perfectly avoided, the nerves are easily separated, and the diseased tissues are quickly removed.

【Quick Knife Experience +1, +1......】

His whole being entered a state of extreme madness.

With the support of six-level debridement, incision, and dissection, he doesn't even need the stable knife method to restrain the magic of the quick knife method, and he can also ensure the safety of the patient.

This is not the first attempt, but after his dissection technique was promoted to the sixth level, he has already begun to consciously try it in minor surgery.

Keep practicing and exploring.

The stable knife method and the fast knife method can be used separately or the two together.

So far, I'm afraid that only Zhou Can can fuse the quick knife method with the stable knife method.

Not even Dr. Koh could do it.

Three different knife techniques that can be applied to different occasions.

It can be carried out according to the actual clinical needs.

It took six minutes and fifty-eight seconds to complete the operation, which was close to seven minutes.

"Doctor, has my abscess been cleared? Don't relapse! The last surgery I had at the county hospital didn't take long for it to relapse. ”

The patient is under local anesthesia and the person is awake all the time.

Seeing Zhou Can take over the operation for him, he didn't say anything.

It's just that Zhou Can's surgery speed is too fast, which makes him inevitably feel suspicious.

When Yang Zhi operated on him, it took nearly half an hour before he cut open the abscess cavity, drained the pus in it little by little, and sucked it out.

Now this doctor, who looks younger than Yang Zhi, actually completed all the parts of the operation in just a few minutes. It's a bit unsettling.

Dr. Zhou Can is the leader of our surgical team, and he will personally operate on you, and the effect is more than ten times better than that of my surgery. With good postoperative care, I believe you will experience what is called fast and good abscess debridement surgery. ”

Yang Zhi was on the side to help Zhou Can speak.

Although there is a suspicion of filming Zhou Can's sycophants, what he said is basically the truth.

There are a lot of patients out there who really come to Zhou Can for surgery.

"If your postoperative results are good, don't forget to recommend our Dr. Zhou Can to your relatives and friends!"

Ma Xiaolan also said.

"Haha, good, good! As long as the results of the surgery are good, I will definitely praise others for your excellent medical skills. This time I came to Tuya for treatment, and I also believed in your medical skills, so I came to the provincial capital to find you. ”

The patient was a man of about fifty years old, and he couldn't help but smile happily when he heard that the other doctors and nurses were confident in Zhou Can's medical skills.

……

was busy until more than seven o'clock, and Zhou Can finally finished dealing with all the surgical patients.

In addition to gaining a lot of medical experience, I also gained a lot of exhaustion. As for wanting to reap the gratitude of patients, we have to wait until they recover.

If the patient has an infection or complications after surgery, what he will gain is not gratitude, but may be all kinds of doubts and curses behind his back.

In general, patients and family members rarely curse in front of him.

At most, some people complained to the medical department behind their backs.

"Doctor Zhou, can you please take another shift? A six-year-old girl came to the triage desk, her face was cyanotic and her blood oxygen saturation was only 61%, and the situation looked quite scary. ”

Most of the nurses in the emergency department are familiar with Zhou Can.

He was also kind.

Sometimes, when I meet some critically ill patients, when I see him, I will ask him to come over for help.

Zhou Can basically did not refuse to come.

"Blood oxygen is so low, has the upper respiratory tract been checked?"

Access to oxygen is entirely dependent on the lungs and upper respiratory tract.

When your child's blood oxygen is so low, the first thing to consider is a blockage in the upper airway.

For example, the peanut Mika throat baby that I just rescued not long ago.

"Today is Dr. Xie on the night shift, his experience is limited, and he has checked what should be investigated, but he has not found the cause for the time being. I'm so worried about what happened to that kid, so please come and take a look. ”

"Okay, let's go over and have a look!"

Zhou Can followed the nurse to the triage desk and saw a pair of rather young parents with a six-year-old girl seeking treatment.

The little girl's face and lips are now deeply blue, including the skin on her body.

It's scary.

The patient's mother stood with a limp on one foot and was visibly unnatural.

Zhou Can immediately realized that the child's mother was likely to be a person with a leg disability.

The patient's father is tall, normal, and his face is full of anxiety.

Zhou Can squeezed forward, and Dr. Xie immediately seemed to have seen a savior.

"Dr. Zhou, this child's blood oxygen is only about 60, but no foreign body was found to be stuck in the throat. Please help me take a look. ”

For some doctors who are growing slowly, even if they have worked for five or six years, they will still panic like a child who has not grown up when they encounter such urgent and critical cases.

Because sometimes, the death of a patient is only in a split second.

"How did the child become like this?"

Zhou Can has already begun to check on the child's condition.

Her chest could be seen collapsing as she breathed.

Instructions for inhaling are very laborious.

The little girl was beautiful, lying quietly on the flat bed, looking at Zhou Can innocently with a pair of smart eyes.

At this moment, in the little girl's mind, these doctors and nurses dressed in white are the angels who save her.

"Hmm...... Ahhhh......h

The patient's father gestured with his hands and made a muffled sound.

It turned out to be a dumb one.

Zhou Can looked at the patient's mother.

"Boom ......"

She was equally mute.

The patient's parents are mute and disabled.

I don't know if their daughters are genetic?

"Kid, are you feeling sick now?"

Zhou Can asked the little girl gently.

"Uncomfortable! I feel like there's something holding me down! ”

When she speaks, she speaks clearly.

Explain that there is no problem with hearing and vocalization.

"Uh-huh......"

The patient's father wrote two sentences in a notebook with a pen he carried with him.

"My mother and I are mute, and I am also deaf. My daughter was born a little purple, and today she suddenly fell to the ground, please save her! ”

Only then did Zhou Can find out that the child's father was wearing a hearing aid.

Just now his attention was all on the child, and he didn't notice this.

Nowadays, hearing aids are designed with skin color in order to minimize the probability of discrimination against people with disabilities, taking into account the feelings of people with disabilities.

If you wear it on your ears and don't look closely, it's generally harder to spot.

The patient's father is deaf-mute, and the mother's leg is disabled and mute, which is a vulnerable family.

"Don't worry, we'll do our best to save your child."

Zhou Can comforted the two, and then began to quickly give the child a preliminary physical examination.

For patients with such poor blood oxygen, it is necessary to listen to the chest sound and listen for the breathing sound in the lungs.

With the help of a stethoscope, Zhou Can found that the patient's lungs had clear breath sounds and no murmurs.

He then listens down to the patient's heart.

An indescribable murmur was heard.

Every time the heart beats, it makes this murmur.

His face changed slightly, and his bad luck was looking for the miserable. I thought that the child might have an upper respiratory tract or lung problem, but now it seems that the lesion is likely to be in the heart.

The patient's father responded that the child's face turned a little purple since he was a child, indicating that the course of the disease had lasted for many years.

If nothing else, it is likely to be congenital heart disease.

Zhou Can has rich experience in cardiothoracic surgery diagnosis, as well as pediatric diagnosis experience, and has encountered many patients with congenital heart disease.

Even if he does not do any auxiliary tests now, he can preliminarily conclude that 99% of the patients have congenital heart disease.

"Children, don't be afraid, uncle needs to check your chest and rib area, and you need to take off the clothes on your upper body!"

Considering that the patient is a girl.

Before the examination, Zhou Can obtained the consent of the patient and the family as much as possible.

In fact, in the eyes of doctors and nurses, as long as they enter the hospital, there is really no big difference between men and women. When you go to the operating room for a slightly larger operation, you basically don't wear an inch, or wear a hospital-issued surgical gown.

If you are admitted to the ICU, you should take off your clothes 100%.

Depending on the situation, patients may be given a hospital-issued gown.

Therefore, if you want to say that when a male doctor examines a sensitive part of the body of a female patient, there will be oblique thoughts and the like, which is basically impossible. At most, it is to see young and beautiful female patients, which brings some visual enjoyment.

There are many male doctors who do electrocardiogram and other tests on female patients, and they often ask the patient to undress herself and tell her what to do. The male doctor will deliberately turn around and fiddle with the examination equipment so as not to embarrass the female patient.

Then, after placing the test probe on the examination site of the female patient, it will quickly take the initiative to help them cover their clothes to cover the sensitive area.

In order to reduce the embarrassment of female patients.

(End of chapter)